Departamento de Radiologia e Oncologia - FM/MDR

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O Departamento de Radiologia e Oncologia da Faculdade de Medicina da USP (FMUSP) é responsável pelos programas de graduação e pós-graduação nas áreas de Oncologia e Radiologia, oferecendo programas de Mestrado (Oncologia) e Doutorado (Oncologia e Radiologia).Como apoio às atividades de ensino e pesquisa o Departamento dispõe de uma estrutura que comporta uma Biblioteca especializada em Radiologia e Medicina Nuclear, Secretarias de Graduação e Pós-Graduação, um Centro de Pesquisa Clínica e Laboratórios de Investigação Médica em Oncologia Experimental, Medicina Nuclear e Ressonância Magnética em Neurorradiologia.

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article 2 Citação(ões) na Scopus
Partial Directed Coherence and the Vector Autoregressive Modelling Myth and a Caveat
(2022) BACCALA, Luiz A.; SAMESHIMA, Koichi
Here we dispel the lingering myth that Partial Directed Coherence is a Vector Autoregressive (VAR) Modelling dependent concept. In fact, our examples show that it is spectral factorization that lies at its heart, for which VAR modelling is a mere, albeit very efficient and convenient, device. This applies to Granger Causality estimation procedures in general and also includes instantaneous Granger effects. Care, however, must be exercised for connectivity between multivariate data generated through nonminimum phase mechanisms as it may possibly be incorrectly captured.
article 0 Citação(ões) na Scopus
Development of a Prognostic Model for Early Breast Cancer Integrating Neutrophil to Lymphocyte Ratio and Clinical-Pathological Characteristics
(2024) FARIA, Sara Socorro; GIANNARELLI, Diana; LIMA, Vladmir Claudio Cordeiro de; ANWAR, Sumadi Luckman; CASADEI, Chiara; GIORGI, Ugo De; MADONNA, Gabriele; ASCIERTO, Paolo Antonio; LOPEZ, Rossana Veronica Mendoza; CHAMMAS, Roger; CAPONE, Mariaelena
Background Breast cancer-related inflammation is critical in tumorigenesis, cancer progression, and patient prognosis. Several inflammatory markers derived from peripheral blood cells count, such as the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII) are considered as prognostic markers in several types of malignancy.Methods We investigate and validate a prognostic model in early patients with breast cancer to predict disease-free survival (DFS) based on readily available baseline clinicopathological prognostic factors and preoperative peripheral blood-derived indexes.Results We analyzed a training cohort of 710 patients and 2 external validation cohorts of 980 and 157 patients with breast cancer, respectively, with different demographic origins. An elevated preoperative NLR is a better DFS predictor than others scores. The prognostic model generated in this study was able to classify patients into 3 groups with different risks of relapse based on ECOG-PS, presence of comorbidities, T and N stage, PgR status, and NLR.Conclusion Prognostic models derived from the combination of clinicopathological features and peripheral blood indices, such as NLR, represent attractive markers mainly because they are easily detectable and applicable in daily clinical practice. More comprehensive prospective studies are needed to unveil their actual effectiveness. This study aimed to establish and validate a prognostic model using an approach to predict disease-free survival based on readily available baseline clinical-pathological prognostic factors and preoperative blood count-derived lymphocyte ratios.
article 0 Citação(ões) na Scopus
Impact of cannabidiol on brain glucose metabolism of C57Bl/6 male mice previously exposed to cocaine
(2024) SPELTA, Lidia Emmanuela Wiazowski; REAL, Caroline Cristiano; BRUNO, Vitor; BUCHPIGUEL, Carlos Alberto; GARCIA, Raphael Caio Tamborelli; TORRES, Larissa Helena; FARIA, Daniele de Paula; MARCOURAKIS, Tania
Despite evidence of the beneficial effects of cannabidiol (CBD) in animal models of cocaine use disorder (CUD), CBD neuronal mechanisms remain poorly understood. This study investigated the effects of CBD treatment on brain glucose metabolism, in a CUD animal model, using [F-18]FDG positron emission tomography (PET). Male C57Bl/6 mice were injected with cocaine (20 mg/kg, i.p.) every other day for 9 days, followed by 8 days of CBD administration (30 mg/kg, i.p.). After 48 h, animals were challenged with cocaine. Control animals received saline/vehicle. [F-18]FDG PET was performed at four time points: baseline, last day of sensitization, last day of withdrawal/CBD treatment, and challenge. Subsequently, the animals were euthanized and immunohistochemistry was performed on the hippocampus and amygdala to assess the CB1 receptors, neuronal nuclear protein, microglia (Iba1), and astrocytes (GFAP). Results showed that cocaine administration increased [F-18]FDG uptake following sensitization. CBD treatment also increased [F-18]FDG uptake in both saline and cocaine groups. However, animals that were sensitized and challenged with cocaine, and those receiving only an acute cocaine injection during the challenge phase, did not exhibit increased [F-18]FDG uptake when treated with CBD. Furthermore, CBD induced modifications in the integrated density of NeuN, Iba, GFAP, and CB1R in the hippocampus and amygdala. This is the first study addressing the impact of CBD on brain glucose metabolism in a preclinical model of CUD using PET. Our findings suggest that CBD disrupts cocaine-induced changes in brain energy consumption and activity, which might be correlated with alterations in neuronal and glial function.
Inflammatory Modifications in Paranasal Sinuses and Ostiomeatal Complex Anatomical Variations in Jet Aircraft Pilots: A Computed Tomography Study
(2024) SILVA, Yeda da; MUNHOZ, Luciana; PARGA FILHO, Jose Rodrigues; DAMASCENO, Andreza Gomes; ROSA, Cesar Felipe Franca da; ZUKOVSKI, Eduardo Bilaqui; TENG, Erik Zhu; ARITA, Emiko Saito; CASTRO, Claudio Campi de
Introduction Jet aircraft pilots are exposed to huge pressure variation during flight, which affect physiological functions as systems, such as the respiratory system.Objectives The objective of the present investigation was to evaluate inflammatory changes of paranasal sinuses of jet aircraft pilots before and after a jet aircraft training program, using multislice computed tomography (CT), in comparison with a group of nonairborne individuals with the same age, sex, and physical health conditions. A second objective of the present study was to assess the association between the ostiomeatal complex obstruction and its anatomical variations.Methods The study group consisted of 15 jet aircraft pilots participating in the training program. The control group consisted of 41 nonairborne young adults. The 15 fighter pilots were evaluated before initiating the training program and after their final approval for the presence of inflammatory paranasal sinus disease. The ostiomeatal complex anatomical variations and obstructions were analyzed in pilots after the training program.Results Jet aircraft pilots presented higher incidence of mucosal thickening in maxillary sinus and anterior ethmoid cells than controls. Prominent ethmoidal bulla showed significant association with obstruction of the osteomeatal complex.Conclusions Jet aircraft pilots present increased inflammatory disease when compared with nonairborne individuals. The presence of a prominent ethmoidal bulla is associated with ostiomeatal complex obstruction.
article 0 Citação(ões) na Scopus
Left-sided epileptiform activity influences language lateralization in right mesial temporal sclerosis
(2024) ALMEIDA, Juliana Passos de; CASTRO, Bettina Martins; PASSARELLI, Valmir; CHAIM, Khallil Taverna; CASTRO-LIMA, Humberto; LISTIK, Clarice; JORGE, Carmen Lisa; VALERIO, Rosa; ARANTES, Paula Ricci; JR, Edson Amaro; PIPEK, Leonardo Zumerkorn; CASTRO, Luiz H.
Objective: To investigate the association between left epileptiform activity and language laterality indices (LI) in patients with right mesial temporal sclerosis (MTS).Methods: Twenty-two patients with right MTS and 22 healthy subjects underwent fMRI scanning while performing a language task. LI was calculated in multiple regions of interest (ROI). Data on the presence of left epileptiform abnormalities were obtained during prolonged video-EEG monitoring.Results: After correction for multiple comparisons, LI was reduced in the middle temporal gyrus in the left interictal epileptiform discharges (IED+) group, compared with the left IED- group (p < 0.05).Significance: Using a responsive reading naming fMRI paradigm, right MTS patients who presented left temporal interictal epileptiform abnormalities on video-EEG showed decreased LI in the middle temporal gyrus, indicating decreased left middle temporal gyrus activation, increased right middle temporal gyrus activation or a combination of both, demonstrative of language network reorganization, specially in the MTG, in this patient population.Plain Language Summary: This research studied 22 patients with right mesial temporal sclerosis (a specific type of epilepsy) comparing them to 22 healthy individuals. Participants were asked to perform a language task while undergoing a special brain imaging technique (fMRI). The findings showed that patients with epilepsy displayed a change in the area of the brain typically responsible for language processing. This suggests that their brains may have adapted due to their condition, altering the way language is processed.
article 0 Citação(ões) na Scopus
Not Only RET but NF1 and Chromosomal Instability Are Seen in Young Patients with Sporadic Medullary Thyroid Carcinoma
(2024) CASTRONEVES, Luciana Audi; MANGONE, Flavia Regina Rotea; LERARIO, Antonio Marcondes; MERCANTE, Ana Maria da Cunha; BATISTA, Rafael Loch; BARROS, Luciana Rodrigues Carvalho; FERREIRA, Carla Vaz; FARIAS, Evelin Cavalcante; VANDERLEI, Felipe Augusto Brasileiro; MAIA, Ana Luiza; NAGAI, Maria Aparecida; JORGE, Alexander Augusto Lima; HOFF, Ana Oliveira
Context Genetic analysis of sporadic medullary thyroid carcinoma (MTC) has revealed somatic variants in RET, RAS, and occasionally other genes. However, around 20% of patients with sporadic MTC lack a known genetic driver.Objective To uncover potential new somatic or germline drivers, we analyze a distinct cohort of patients with sporadic, very early-onset, and aggressive MTC.Methods Germline and somatic DNA exome sequencing was performed in 19 patients, previously tested negative for germline RET variants.Results Exome sequencing of 19 germline samples confirmed the absence of RET and identified an NF1 pathogenic variant in 1 patient. Somatic sequencing was successful in 15 tumors revealing RET variants in 80%, predominantly p.Met918Thr, which was associated with disease aggressiveness. In RET-negative tumors, pathogenic variants were found in HRAS and NF1. The NF1 germline and somatic variants were observed in a patient without a prior clinical diagnosis of neurofibromatosis type 1, demonstrating that the loss of heterozygosity of NF1 functions as a potential MTC driver. Somatic copy number alterations analysis revealed chromosomal alterations in 53.3% of tumors, predominantly in RET-positive cases, with losses in chromosomes 9 and 22 being the most prevalent.Conclusion This study reveals that within a cohort of early-onset nonhereditary MTC, RET remains the major driver gene. In RET-negative tumors, NF1 and RAS are drivers of sporadic MTC. In addition, in young patients without a RET germline mutation, a careful clinical evaluation with a consideration of germline NF1 gene analysis is ideal to exclude Neurofibromatosis type 1 (NF1).
article 0 Citação(ões) na Scopus
PI4K2A: a novel potential therapeutic target for lung cancer
(2024) BALDAVIRA, Camila Machado; PRIETO, Tabatha Gutierrez; NAGAI, Maria Aparecida; CAPELOZZI, Vera Luiza
article 0 Citação(ões) na Scopus
Prognostic Impact of Primary Tumor Sidedness in Stage III Colorectal Cancer: Real-World Evidence from a Brazilian Cohort
(2024) PROTASIO, Bruno Medonca; CASTRIA, Tiago Biachi de; NATALINO, Renato; MANGONE, Flavia R.; SARAGIOTTO, Daniel Fernandes; SABBAGA, Jorge; HOFF, Paulo M.; CHAMMAS, Roger
The prognostic impact of primary tumor sidedness (PTS) in stage III CRC was analyzed retrospectively. Transverse colon tumors, multicentric tumors, and undetermined primary subsites were excluded, totaling 234 patients classified according to PTS: 95 on the right side (40.6%) and 139 on the left side (59.4%). The 5-year OS probabilities for right-sided and left-sided tumors were 67% (CI 95%; 58%-77%) and 82% (CI 95%; 75%-89%), respectively (HR: 2.02; 95% CI: 1.18-3.46; P = .010) Background: Primary tumor sidedness (PTS) is an independent prognostic factor in patients with metastatic colorectal cancer (CRC), with a worse prognosis for right-sided tumors. There are limited data on the prognostic impact of PTS in stage III CRC. The main objective of this study was to analyze the prognostic impact of PTS in stage III CRC. Patients and Methods: A retrospective and uni-institutional cohort study was performed in an oncology reference center. Patients with stage III CRC treated with a 5-fluorouracil and oxaliplatin-based chemotherapy regimen (mFLOX regimen) from October 2007 to February 2013 were included. The primary outcome was the probability of overall survival (OS) at 5 years stratified by PTS. Secondary outcomes were the probability of disease-free survival (DFS) at 5 years and an analysis of the prognostic impact of clinical and molecular biomarkers. Kaplan-Meier curves were used, and Cox models were used to evaluate prognostic factors associated with OS and DFS. Results: Overall, 265 patients were evaluated. Transverse colon tumors, multicentric tumors, and undetermined primary subsites were excluded, resulting in 234 patients classified according to PTS: 95 with right sidedness (40.6%) and 139 with left sidedness (59.4%). The median follow-up time was 66 months [interquartile range (IQR): 39-81]. The 5-year OS probabilities for right-sided and left-sided tumors were 67% (95% CI: 58%-77%) and 82% (75%-89%), respectively [hazard ratio (HR): 2.02, 95% CI: 1.18-3.46; P = .010]. The 5-year probabilities of DFS for right-sided and left-sided tumors were 58% (49%-69%) and 65% (58%-74%), respectively (HR: 1.29, 0.84-1.97; P = 0.248). Conclusion: These data suggest that there may be a worse prognosis (inferior OS at 5 years) for resected right-sided stage III CRC patients treated in the real world. However, these data need to be confirmed by prospective studies with a larger number of participants.
article 0 Citação(ões) na Scopus
Saúde cardiovascular e habitação: um diálogo importante travado nos assentamentos precários de São Paulo
ABSTRACT The reduction of infectious diseases and longer life favored the greater prevalence of chronic diseases such as cancer, diabetes, cardiovascular and respiratory diseases. In general, the geographical scale of studies on socioeconomic conditions and health problems is the municipality. In this geographical scale there is no clear separation between the types of settlement. Intraurban studies by type of settlement can contribute to a more faithful portrait on inequalities in living conditions. In this study, data from residents of the municipality of São Paulo were analyzed who were admitted and those who died, by diseases of the circulatory system from 2010 to 2016 for deaths and from 2011 to 2016, for hospitalizations. Each hospitalization and death was attributed to the settlement of housing according to type: non-regular settlement, precarious or regular. The following calculations were made: proportion of hospital admissions by the Unified Health System (SUS) by groups of causes, standardized rates by gender and age group, hospitalization/inhabitant according to sex, age group and type of settlement and standardized rates by gender and age standardized mortality rates due to circulatory diseases. The results found an even more wicked situation in precarious settlements for all age groups, both sexes. The difference in cardiovascular health between the three types of settlements, evaluated through the proportions of hospital hospitalizations and mortality rates, show that almost 1,700,000 people in São Paulo are in a major disadvantage compared to the group formed by 85% of the population. In terms of hospitalizations, rates are higher in non-regular settlement. In this sense, it can be speculated that there is greater access to health service for residents of non-regular settlement in relation to those of precarious settlements. This access is reverted to lower mortality when the rates of both groups are compared. If we consider only two groups (regular and non-regular settlements), the situation of greater disadvantage in precarious settlements is diluted, becoming invisible. Such results can provide health surveillance to define specific programs for these settlements, as well as territory management, in general, to provide better housing conditions.
Manual de oncologia torácica